Watch and wait before treating ear infections, advise paediatricians

Doctors should watch and wait before treating most ear infections with antibiotics in healthy children over six months of age, according to new recommendations from the Canadian Paediatric Society (CPS).

“The diagnosis of an ear infection can be incorrect and some are caused by viruses rather than bacteria,” says Dr. Joan Robinson, author of the new CPS statement published this week in Paediatrics & Child Health and a member of the CPS Infectious Disease and Immunization Committee. “Also, some kinds of bacterial infections are likely to go away without antibiotics because the immune system alone is adequate.”

Ear infections are extremely common. Seventy-five per cent of children will have at least one episode by the time they are one year old. Caused by viruses or bacteria, they usually start on about the third day of a common cold. Symptoms include unexplained fever, difficulty sleeping, tugging or pulling at the ears, and overall irritability.

“Rarely, children have fluid draining from their ear. This fluid could contain germs. The best way to prevent the spread of these germs is to wash your hands well,” says Dr. Robinson.   

Ear infections are usually not serious and not contagious; the colds that cause ear infections are, however, contagious.

“Most children will have relief with just acetaminophen or ibuprofen,” says Dr. Robinson. “However, the message to parents is, if your child has a cold and then develops signs of an ear infection; take them to the doctor to check it out.”

The statement lists several ways to help prevent children from getting an ear infection including:

  • breastfeeding babies,
  • avoiding bottle feeding a baby who is lying down,
  • refraining from using a pacifier too often,
  • avoiding exposure to cigarette smoke and,
  • vaccinating children with the influenza and pneumococcal conjugate at the recommended age.

The Canadian Paediatric Society is a national professional association, representing more than 2,200 paediatricians, which advocates for the health needs of children and youth.

Source: Canadian Paediatric Society
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